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  1. #1
    Join Date
    Aug 2012
    Posts
    4

    Default Employer Denies Injuries are Work-Related

    Please help!

    I was injured on the job 1/10! The employer is not denying that the incident happened, but they are denying the injuries sustained. I have been unable to work since the accident. Subsequently, I have been fired from my position. The insurance company did send me to their doctor in the beginning and this guy stated nothing was wrong with me after seeing me for 5 minutes and sent me packing! Insurance company refused second opinion and I had to seek out treatment on my own!

    Since the injury, I have been seeing my own physicians (Neurologist, primary and an orthopedic surgeon), I have been diagnosed with post concussive syndrome, cervicogenic headaches, and have had surgery on my shoulder. I have memory problems and headaches daily. The headaches are so bad, to the point where I cannot function and am in bed for hours crying!

    The first attorney I had hired, was basically too busy to handle my case and cancelled a mediation with the insurance carrier without my knowledge, never filed for a change of physician or any hearing of any sort. I tried for months to work with this attorney and he would always give me the run around so I fired him and hired a new attorney (Oct. 2011) . The new attorney rescheduled the mediation with the insurance company in April 2011. The insurance company offered to settle my case at some low, low offer and that I would not agree to because I still need treatment! According to my attorney, back in April, he was going to file for a hearing with the commission for medical coverage and pay check.

    In June, I received some paperwork from the insurance carrier stating that they were sending me for an IME. In July I seen their Dr and he felt so sorry for me that he even went as far as to write prescriptions for me! He also proceeded to ask me why the insurance carrier would deny this case. He believes that there is something “fishy” going on! In his letter to the insurance company he agrees with all of the physicians that I have seen thus far and that the injuries received where indeed related to the accident that occurred on the job. He acknowledges that I am not at MMI and further treatment is needed.

    This past week I called that NC WC commission to find out why I have not been scheduled for a hearing that was applied for in April and was told that my "new" attorney has not filed any paper work since the change of attorney was filed back in October. Now my attorney is stating that this was a “misunderstanding” and that he never stated he was filing for a hearing! Am I wrong to think that I need to get in front of a judge to make a decision here?? I am so sick of getting the runaround, I just do not know what to do next. I have tried and tried with BOTH attorneys, no one seems to want to help me, and now I am beginning to think something “fishy” is going on! I am livid and I just do not know what else to do or whom I can talk too!

    Any advice? I have lost my job, my savings, my home and am now living with friends!

  2. #2
    Join Date
    Feb 2007
    Location
    831 East Morehead St., Ste 355, Charlotte, NC 28202
    Posts
    3,808

    Default Re: No Where else to Turn

    IF your claim is "denied" then you probably do need to proceed to a hearing. But from your post, I cannot tell that you are denied. It seems to me that part of your claim is accepted--after all, they did send you to an IME--- and perhaps your claim is only partially denied. In that situation, I would normally request a hearing for my client. If you cannot get issues worked out with the insurance carrier through negotiation or mediation, then your only other reasonable option is to have a hearing.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney and Board Certified Specialist in NC Workers' Compensation Law

  3. #3
    Join Date
    Aug 2012
    Posts
    4

    Default Re: No Where else to Turn

    The claim was accepted but they are saying that the injuries did not occur from the accident. Originally when I was injured they accepted the claim and sent me to see their ortho dr. After he examined me he had me on restrictions for a week and the next visit he cleared me ortho wise and stated I needed to see a neuro dr. This is when it got ugly because the IC said there was no need! I tried to continue to work and was unable, subsequently being fired. My primary sent me for a brain scan and to a new ortho and a neuro dr! Ortho found shoulder issues and surgery was done! Neuro doc has found the other issues! Mean time the IC refuses to talk ( state employee). My new attorney was able to get them to the table for mediation but that was a joke they offered me 2000.00 and said that was it! I was told by my attorney I needed to go through mediation before we could file for any hearing! The mediation was in April and this entire time since the attorney said he had filed for a hearing and supposedly getting depositions from all the drs. I cannot afford anymore out of pocket to see my drs as I am bankrupt now, so I have been without treatment for 9 months now! In the meantime I have been calling attorneys office twice a month since april banking on this hearing! Every time the paralegal and attorney assured me that they were just waiting to hear back from the commission with a date! When I received a letter in June from the insurance carrier about the IME I of course called the attorney and they had no idea the IC wanted the IME! Now that the IME is over and their own dr agrees with my doctors where do I go from here? My attorney is not responding to my calls and I have taken a copy of the IME over to his office personally! I am at a loss as to what I should do next if my attorney is doing anything or not because I can not get an answer from him or a return call!

  4. #4
    Join Date
    Feb 2007
    Location
    831 East Morehead St., Ste 355, Charlotte, NC 28202
    Posts
    3,808

    Default Re: No Where else to Turn

    Sounds like you have a medical causation issue in your case. Doctor depos are required to resolve that, and those depos normally do not happen until after the hearing. Normally, the parties do not mediate unless a hearing has been requested. So some of the facts in your post don't really make sense to me.

    Encourage your attorney to move aggressively on your case. And ask them to check on the hearing date. It may be that they filed the paperwork but the Commission does not have it properly coded.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney and Board Certified Specialist in NC Workers' Compensation Law

  5. #5
    Join Date
    Aug 2012
    Posts
    4

    Default Re: No Where else to Turn

    I appreciate you taking the time to respond! I agree that none of this makes any sense!
    I guess I should have mentioned the cause of injury! While I was leaving work, a slab of slate fell off the roof top and hit me causing me to fall to the ground! I tried to break the fall with my arms. I have witnesses and that is why the IC has not denied the accident but the adjuster does not feel the injuries occurred!
    Seems to me that both of the attorneys I have had have not been aggressive! I guess I will have to sit in his office until he talks to me!
    Thanks again!

  6. #6
    Join Date
    Feb 2012
    Posts
    349

    Default Re: No Where else to Turn

    RNBSN,
    I am sad that you are having such a difficult time with this. Thank God I don't live in your state. Two different lawyers and neither seems to have done their job for you. If it were me I think I would be searching for another one. Surely you won't find another one like the first two. I'm no lawyer but I do know you should have had a hearing date long before now.

  7. #7
    Join Date
    Apr 2012
    Location
    Oregon
    Posts
    347

    Default Re: No Where else to Turn

    You should hire Bob, complwyr, because he is in NC and he rocks!

  8. #8
    Join Date
    Jul 2012
    Posts
    6

    Default Re: No Where else to Turn

    Dear RNBSN, I feel your pain! I am so sorry that you are encountering such trouble. I too had a "used car salesman" for an attorney who--Bless God--fired himself after wasting months of my time. Because I hired an attorney, the IC really started dragging their feet. I felt as though I was being punished. The attorney did little to protect me; and I returned to work in great pain and w/o treatment in order to keep my job after being betrayed by my then treating doctor. I didn't know a thing about WC prior to being injured and only retained an attorney because both the ER HR Rep/IC "nurse" kept calling/harrassing me all through medical leave--which was brief.

    I discovered that retaining a competent WC attorney is a painstaking search which, unfortunately, is discovered through trial/error and much wasted time. It is very discouraging to be physically hurt, in pain, w/o treatment, w/o a job, and w/o decent legal representation to fight for you. Decent WC attorneys are out there and some of the key things to look for are: What percentage of their practice is dedicated to WC? A firm that is dedicated only to WC is probably the best way to go, if you can find one. Seek out referrals from reputable P/I law firms in your area, because PI/WC are closely related fields and the attornies often network/send each other business. How much experience does the attorney have w/your particular injury/case? Do they have trial experience if it is necessary to go that far? Does the firm/attorney have the resources to go the distance if necessary? Since WC is on a State-limited contingency fee basis, it makes it difficult to find a good WC attorney. An attorney who is not worried about how much it will cost them to work the case, is one who will aggressively represent you knowing that the more successful the outcome of your case is, the more his State-limited fee will be. Does the attorney/firm also represent any ER clients? Some firms do. I am sure (yeh, right!) that they are able to behave ethically w/o compromising, selling out the IW client, or cutting backroom deals w/both the ER/IC at the expense of the IW. And, How available is the attorney to take your calls/receive any info that is considered time-sensitive/urgent? A good WC attorney is often busy, but a competent one usually has some system of relaying/receiving information w/the IW client (a good paralegal/assistant, email, etc). If he needs to communicate w/his client, he will take the time to call them. After all, the IW is the client and therefore a customer. Customer service rules!

    The WC system sucks! The laws are definitely not in favor of an IW. The experience is physically painful, financially devastating, discouraging, disheartening, depressing, extremely stressful, and life altering. IW's want to sit down and not get up, cry, and throw in the towel. I say do all those things Once you are done sitting--Get up! Use the towel thrown in to dry your eyes and--Get up! Do not give up, RNBSN. I am not telling you anything that I have not done myself. If you keep going, you will get a breakthrough somewhere in the journey--things will turn around. If we IW'S give up, then the sucky system has won and that is not acceptable. Once a person has lost everything because of this experience, then there is nothing more to lose. So we must fight on. Who is to say that we will not prevail after much travail?

    I finally found a competent attorney after almost a year. I was just about to give up, too. It was just the breakthrough I needed or I would have had to let it go.
    Last edited by icouldscreem; 08-09-2012 at 02:14 PM.
    icouldscreem!

  9. #9
    Join Date
    Aug 2012
    Posts
    4

    Default Re: No Where else to Turn

    Icouldscream thank you for the insight and your time! I feel as though I have been beat up so many times through this journey and with no reprieve! Sometimes I feel as though I am being punished for the curve ball I have been thrown! I work hard to make sure that life is good not only for my family but for the people I (use) to care for! To see fellow members of the medical field take the "dark side" and a total disregard to any oath they have taken really burns me up! I have dedicated half of my life to ensure the safety and care of my patients and no matter what came into my direction, I never thought twice about betraying the people I cared for or worked for! I am disgusted with the fact that some have absolutely no morals and have so much greed that they are blinded on the fact of what is right and wrong is!

    I am a firm believer in karma and one day they will receive what they deserve!

    I took a huge paycut by taking on this job because I wanted to make a difference!!! This job was one that intrigued me, one that I could make a difference in a large portion of the community! These people live the rest of their lives being provided care in what anyone would know is less then standard care and depending on others to maintain their dignity! The government left this community with no means to have quality care and by prolonging my medical care, they are not only preventing me from providing for my family but they are also taking me away from the patients/ job that I love! I did not ask for this journey nor do I want to be living in it! I just want to be well and back up to speed so that I can work again doing what I love and looking out for my community!
    Last edited by RNBSN; 08-10-2012 at 05:36 AM.

  10. #10
    Join Date
    Feb 2007
    Location
    831 East Morehead St., Ste 355, Charlotte, NC 28202
    Posts
    3,808

    Default Re: No Where else to Turn

    I sent you a new PM. BB
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney and Board Certified Specialist in NC Workers' Compensation Law

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